Free download Obstetric and Gynecological Nursing (PDF)

by Meselech Assegid, Alemaya University

Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00.

 

This lecture note offers nurses comprehensive knowledge necessary for the modern health care of women with up-todate clinically relevant information in women’s health care. It addresses and contains selected chapters and topics which are incorporated in the obstetrics and gynecology course for nurses. However, a major focus is provided on the role of the nurse in providing quality maternal and newborn care.

Topics covered includes: Anatomy of Female Pelvis and The Fetal Skull, Normal Pregnancy, Normal Labour, Normal Puerperium, Abnormal Pregnancy, Abnormal Labour, Abnormal Puerperium, Induction of Labour, Obstetric Operations and Infection of the Female Reproductive Organs.

link: http://www.freebookcentre.net/medical_books_download/Obstetric-and-Gynecological-Nursing-%28PDF-336P%29.html

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Maternal and Neonatal Care

Because of its profound emotional implications for mother and child, maternal-neonatal care requires expertise that goes beyond clinical skills. Such care must combine clinical competence, sensitivity, and good judgment. It must consider the patient's sexuality and self-image and recognize changing social attitudes and values—especially those concerning conventional and alternative methods of conception and childbirth.

More than 4 million infants are born in the United States each year. Many are born with considerably less medical intervention than was customary in previous decades, and many were conceived with considerably more intervention. As a result, nurses today must be prepared to implement or assist with a wide range of procedures.

If you're working with a pregnant patient, you'll need to use your teaching skills. For instance, you may be called on to organize and direct natural childbirth classes or to teach the mother-to-be how to breathe and control pain during childbirth. You may teach fathers and other support persons to participate in childbirth by providing comfort and direction.

You may also be asked to give information about childbirth options. Although most births still occur in a hospital, many parents inquire about delivery in a birth center. Usually located on the maternity unit of a hospital or sponsored by a childbirth association, a birth center combines the advantages of a homelike setting with the emergency medical and nursing interventions available in a hospital. Today's nurse may staff or direct the birth center.

Historically, the midwife has been a fixture in remote or poor communities. Today's professional nurse-midwife, however, brings advanced technical skills and certification to diverse communities—urban center to country town alike. She may work in collaboration with—or be supervised by—a physician or a group. In some areas, she may even practice independently. In fact, several states permit insurers to make direct payment to the nurse-midwife for her services.

Accompanying the changes in maternity care are changes in neonatal care—thanks to advanced knowledge and techniques for improving fetal monitoring and promoting neonatal survival. New clinical evaluation methods, combined with new electronic and biochemical monitoring techniques, allow improved neonatal care. To make use of these advances, you must be familiar with neonatal physiology, procedures, and equipment.

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Achieving Healthy Mother, Baby, and Family Unit

INTRODUCTION TO MATERNITY NURSING

Providing care to childbearing families is aimed at the ideal of having every pregnancy result in a healthy mother, baby, and family unit. The nurse today faces many evolving and challenging issues in achieving this goal. Such advances as in vitro fertilization and embryo freezing have afforded people opportunities once thought impossible. An increasing number of high-risk pregnancies result from such factors as drug abuse, acquired immunodeficiency syndrome, late or no prenatal care, teenage pregnancies, and pregnancies in women older than age 35. Technologic advances in high-risk obstetric units, fetal monitoring, sonography, and neonatal intensive care units are now providing the means to improve maternal health and save fetuses and infants who would not have survived years ago.

Today's childbearing families have many options. The planned birth may take place in the traditional hospital setting, a birthing center, or at home. The primary care provider may be a physician, a certified nurse-midwife, or a lay midwife. Birth-related choices commonly include the use of labor, delivery, and recovery rooms or labor, delivery, recovery, and postpartum rooms; various birthing positions and analgesic methods; alternative pain-relief strategies such as hydrotherapy; and the decision to allow children and others to be present during labor and delivery. Regionalization of obstetric services has provided childbearing families with access to the technologic advances and skilled personnel capable of managing pregnancy or neonatal complications.

Economic changes in the health care climate have dramatically affected the practice of nursing as cost-containment considerations have shortened the hospital length of stay. Many hospitals have adopted a practice of 12- to 24-hour discharge after delivery coordinated with home health care follow-up.

This combination of advancing technology, pregnancy risk factors, and changing economics challenges the nurse to be a highly skilled clinician and outstanding communicator.

 

TERMINOLOGY USED IN MATERNITY NURSING

• Gestation—pregnancy or maternal condition of having a developing fetus in the body.
• Embryo—human conceptus up to the 10th week of gestation (8th week postconception).
• Fetus—human conceptus from 10th week of gestation (8th week postconception) until delivery.
• Viability—capability of living, usually accepted as 24 weeks, although survival is rare.
• Gravida (G)—woman who is or has been pregnant, regardless of pregnancy outcome.
• Nulligravida—woman who is not now and never has been pregnant.
• Primigravida—woman pregnant for the first time.
• Multigravida—woman who has been pregnant more than once.
• Para (P)—refers to past pregnancies that have reached viability.
• Nullipara—woman who has never completed a pregnancy to the period of viability. The woman may or may not have experienced an abortion.
• Primipara—woman who has completed one pregnancy to the period of viability regardless of the number of infants delivered and regardless of the infant being live or stillborn.
• Multipara—woman who has completed two or more pregnancies to the stage of viability.
• Living children—refers to the number of children a woman has delivered who are living.

A woman who is pregnant for the first time is a primigravida and is described as Gravida 1 Para 0 (or G1P0). A woman who delivered one fetus carried to the period of viability and who is pregnant again is described as Gravida 2, Para 1. A woman with two pregnancies ending in abortions and no viable children is Gravida 2, Para 0.

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